Tag Archives: Clitoris/surgery

Subheading of MeSH term Clitoris

Management of painful clitoral neuroma after female genital mutilation/cutting. 

FREEReprod Health. 2017 Feb 8;14(1):22. doi: 10.1186/s12978-017-0288-3.

Management of painful clitoral neuroma after female genital mutilation/cutting.

Abdulcadir J, Tille JC, Petignat P.


BACKGROUND: Traumatic neuromas are the result of regenerative disorganized proliferation of the proximal portion of lesioned nerves. They can exist in any anatomical site and are responsible for neuropathic pain. Post-traumatic neuromas of the clitoris have been described as an uncommon consequence of female genital mutilation/cutting (FGM/C). FGM/C involves partial or total removal of the female genital organs for non-therapeutic reasons. It can involve cutting of the clitoris and can cause psychological, sexual, and physical complications. We aimed to evaluate the symptoms and management of women presenting with a clitoral neuroma after female genital mutilation/cutting (FGM/C). METHODS: We identified women who attended our specialized clinic for women with FGM/C who were diagnosed with a traumatic neuroma of the clitoris between April 1, 2010 and June 30, 2016. We reviewed their medical files and collected socio-demographic, clinical, surgical, and histopathological information. RESULTS: Seven women were diagnosed with clitoral neuroma. Six attended our clinic to undergo clitoral reconstruction, and three of these suffered from clitoral pain. The peri-clitoral fibrosis was removed during clitoral reconstruction, which revealed neuroma of the clitoris in all six subjects. Pain was ameliorated after surgery. The seventh woman presented with a visible and palpable painful clitoral mass diagnosed as a neuroma. Excision of the mass ameliorated the pain. Sexual function improved in five women. One was not sexually active, and one had not yet resumed sex. CONCLUSION: Post-traumatic clitoral neuroma can be a consequence of FGM/C. It can cause clitoral pain or be asymptomatic. In the case of pain symptoms, effective treatment is neuroma surgical excision, which can be performed during clitoral reconstruction. Surgery should be considered as part of multidisciplinary care. The efficacy of neuroma excision alone or during clitoral reconstruction to treat clitoral pain should be further assessed among symptomatic women.

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Clitoral stones are a rare complication of female genital mutilation.

Int J Gynaecol Obstet. 2016 Jul 31.doi: 10.1016/j.ijgo.2016.06.011. [Epub ahead of print]

Clitoral stones are a rare complication of female genital mutilation

Al-Hussaini TK


Female genital mutilation (FGM) is practiced widely in Egypt and is a deeply rooted tradition; although the government has banned the practice, FGM in Egypt dates back to the Pharaonic period, with adherence to the custom remaining widespread. FGM has been described as a direct assault on the clitoris and an indirect assault on female sexuality [1]. FGM is known to be widespread in Egypt, with 91% of all women aged 15–49 years having undergone some form of FGM [2]; in Upper Egypt, the prevalence is thought to be higher stil.

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Technique opératoire: la transposition clitoridienne [Article in French]

J Gynecol Obstet Biol Reprod (Paris). 2015 Mar 24. pii: S0368-2315(15)00074-5. doi: 10.1016/j.jgyn.2015.02.013

Technique opératoire: la transposition clitoridienne [Article in French]

Chevrot A, Lousquy R, Arfi A, Haddad B, Paniel BJ, Touboul C


Female sexual mutilations result in an important physical and mental suffering. A large number of women have been affected and require a global management, including surgical clitoral transposition. This surgical technique is allowing a rapid improvement of clinical symptoms. In this article, we will describe the indications and operative technique of the clitoral transposition.

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A systematic review of the evidence on clitoral reconstruction after female genital mutilation/cutting

Int J Gynaecol Obstet. 2015 Jan 15. pii: S0020-7292(15)00002-8. doi: 10.1016/j.ijgo.2014.11.008. [Epub ahead of print]

A systematic review of the evidence on clitoral reconstruction after female genital mutilation/cutting

Abdulcadir J, Rodriguez MI, Say L


BACKGROUND: Clitoral reconstruction is a new surgical technique for women who have undergone female genital mutilation/cutting (FGM/C).

OBJECTIVES: To review evidence on the safety and efficacy of clitoral reconstruction.

SEARCH STRATEGY: PubMed and Cochrane databases were searched for articles published in any language from database inception until May 2014. Search terms related to FGM/C and clitoral reconstruction were used in various combinations.

SELECTION CRITERIA: Studies of any design that reported on safety or clinical outcomes (e.g. appearance, pain, sexual response, or patient satisfaction) associated with clitoral reconstruction after FGM/C were included.

DATA COLLECTION AND ANALYSIS: Evidence was summarized and systematically assessed via a standard data abstraction form.

MAIN RESULTS: Four of 269 identified articles were included. They were fair to poor in quality. Summary measures could not be computed owing to heterogeneity. The studies reported on immediate surgical complications, clitoral appearance, dyspareunia or chronic pain, and clitoral function postoperatively via non-standardized scales.

CONCLUSIONS: Women who request clitoral reconstruction should be informed about the scarcity of evidence available. Additional research is needed on the safety and efficacy of the procedure to identify both long-term outcomes and which women might benefit.

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Symptoms of posttraumatic stress disorder after ritual female genital surgery among bedouin in Israel: myth or reality?

Prim Care Companion J Clin Psychiatry. 2008;10(6):453-6.FREE

Symptoms of posttraumatic stress disorder after ritual female genital surgery among bedouin in Israel: myth or reality?

Applebaum J, Cohen H, Matar M, Abu Rabia Y, Kaplan Z.

Ministry of Health, Mental Health Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. juliaa@bgu.ac.il


OBJECTIVE: Ritual female genital surgery (RFGS), or female circumcision, is common among certain ethnic groups in Asia and Africa and describes a range of practices involving complete or partial removal of the female external genitalia for nonmedical reasons. Several studies in African populations, in which more severe forms of RFGS are performed, reported an increased prevalence of posttraumatic stress disorder and other psychiatric syndromes among circumcised women than among uncircumcised controls. Among the Bedouin population in southern Israel, RFGS has become a symbolic operation without major mutilation. However, in a study performed in 1999, Bedouin women after RFGS reported difficulties in mother-daughter relationships and trust. This pilot study assessed the mental health of Bedouin women from southern Israel after RFGS compared to age-matched controls without RFGS.

METHOD: The psychological impact of RFGS was assessed in 19 circumcised Bedouin women compared to 18 age-matched controls. The Post Traumatic Stress Disorder Scale, Symptom Checklist, Impact of Event Scale, and a demographics and background questionnaire were used to assess traumatization and psychiatric illnesses. The study was conducted from March to July 2007.

RESULTS: No statistically significant differences were found between the 2 groups.

CONCLUSIONS: The prevailing procedure of RFGS among the Bedouin population of southern Israel had no apparent effect on mental health.

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Rethinking the history of female circumcision and clitoridectomy: American medicine and female sexuality in the late nineteenth century.

J Hist Med Allied Sci. 2008 Jul;63(3):323-47. Epub 2007 Dec 9.

Rethinking the history of female circumcision and clitoridectomy: American medicine and female sexuality in the late nineteenth century.

Rodriguez SW.

001 Wendover Avenue, Lincoln, Nebraska 68502, USA. sarahbeth3001@yahoo.com


During the late nineteenth and early twentieth centuries, there was one kind of female orgasm and it was clitoral; there was also only one kind of healthy sexual instinct for a woman and it was for penetrative sex with her husband. When a woman behaved outside of this normality-by masturbating or by not responding to her husband’s affections-her sexual instinct was seen as disordered. If healthy women, then, were believed only to be sexual within the marital embrace, what better way to explain these errant behaviors than by blaming the clitoris, an organ seen as key to female sexual instinct? Doctors corrected a clitoris in an unhealthy state using one of four surgeries-removing smegma or adhesions between the clitoris and its hood, removing the hood (circumcision), or removing the clitoris (clitoridectomy)-in order to correct a woman’s sexual instinct in an unhealthy state. Their approach to clitoral surgery, at least as revealed in published medical works, was a cautious one that respected the importance of clitoral stimulation for healthy sexuality while simultaneously recognizing its role as cause and symptom in cases of insanity that were tied to masturbation.

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[Epithelial inclusion cyst of the clitoris as a late complication of childhood female circumcision]

Ugeskr Laeger. 2008 Jan 7;170(1):59.

[Epithelial inclusion cyst of the clitoris as a late complication of childhood female circumcision]. [Article in Danish]

Kristensen IB.

Baagøes Allé 8A, 2. th, DK-5700 Svendborg. idabk@dadlnet.dk.


Two cases of epithelial inclusion cyst as a late complication of childhood female circumcision in patients aged 39 and 27 years are reported. Symptoms were interference with sexual intercourse and discomfort during sitting. Surgical treatment of the condition is known to be effective with few complications and gave correct aesthetic and functional results. Histology confirmed the diagnosis of epithelial inclusion cyst.

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Skinning clitorectomy and skin replacement in women with vulvar intra-epithelial neoplasia.

J Plast Reconstr Aesthet Surg. 2009 Mar;62(3):341-5. doi: 10.1016/j.bjps.2008.11.073. Epub 2008 Dec 27.

Skinning clitorectomy and skin replacement in women with vulvar intra-epithelial neoplasia.

Terlou A, Hage JJ, van Beurden M.

Department of Gynaecologic Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.


BACKGROUND AND AIM: Partial or total clitoris amputation for vulvar intra-epithelial neoplasia (VIN) affects quality of life and sexual function and is likely to constitute over-treatment as superficial excision of only the involved, thinly cornified, stratified squamous clitoral epithelium would suffice. For this reason, we applied skinning clitorectomy and replacement of clitoral skin as an organ-sparing surgical therapy for clitoral VIN.

METHODS: Seven consecutive patients presenting with VIN were treated from July 2003 to February 2008. The skin of the glans clitoridis was resected from the underlying spongious tissue by combined hydro-dissection and sharp dissection. The spongiosum was subsequently covered with either a thin skin flap from the inner aspect of the remaining preputium or minor labium, or a split-thickness skin graft taken from the proximal inner aspect of the thigh.

RESULTS: In all patients, the preoperative diagnosis of VIN was confirmed histopathologically. Additionally, micro-invasive carcinoma was found in two. The postoperative course was complicated by haematoma in one patient and a superficial infection in another, but these did not influence the overall satisfactory outcome obtained in all patients. Preoperative sexual function was largely preserved and, after a mean follow-up of 21 months, no recurrence or invasion of the original lesion was observed in any of the patients.

CONCLUSION: We advocate skinning clitorectomy and replacement of its skin as a sound organ-sparing alternative for clitoral amputation in the treatment of clitoral VIN.

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The historical response to female sexuality.l

Maturitas. 2009 Jun 20;63(2):107-11.

The historical response to female sexuality.

Studd J, Schwenkhagen A.

London PMS & Menopause Clinic, 46 Wimpole Street, London W1G 8SD, UK. harley@studd.co.uk


In the past, medical attitudes to female sexuality were grotesque, reflecting the anxiety and hypocrisy of the times. In the medieval world, the population feared hunger, the devil, and women, being particularly outraged and threatened by normal female sexuality. The 19th century attitude was no better as academics confirmed the lower intellectual status of women, particularly if they ventured into education. The medical contribution to this prejudice was shocking, with gynaecologists and psychiatrists leading the way designing operations for the cure of the apparently serious contemporary disorders of masturbation and nymphomania. The gynaecologist, Isaac Baker Brown (1811-1873), and the distinguished endocrinologist, Charles Brown-Séquard (1817-1894) advocated clitoridectomy to prevent the progression to masturbatory melancholia, paralysis, blindness and even death. Even after the public disgrace of Baker Brown in 1866-1867, the operation remained respectable and widely used in other parts of Europe. This medical contempt for normal female sexual development was reflected in public and literary attitudes. There is virtually no novel or opera in the last half of the 19th century where the heroine with “a past” survives to the end. The wheel has turned full circle and in the last 50 years new research into the sociology, psychology and physiology of sexuality has provided a greater understanding of decreased libido and inadequate sexual response in the form of hypoactive sexual desire disorder (HSDD). This is now regarded as a disorder worthy of treatment.

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Epidermoid cyst of the clitoris: an unusual cause of clitoromegaly in a patient without history of previous female circumcision.

J Pediatr Adolesc Gynecol. 2009 Oct; 22(5): e130-2. doi: 10.1016/j.jpag.2008.10.006. Epub 2009 Jul 3.

Epidermoid cyst of the clitoris: an unusual cause of clitoromegaly in a patient without history of previous female circumcision.

Anderson-Mueller BE, Laudenschlager MD, Hansen KA.

Department of Obstetrics and Gynecology, Sanford School of Medicine of the University of South Dakota, Sioux Falls, South Dakota, USA.

STUDY OBJECTIVE: To describe a rare cause of clitoromegaly. SETTING: University Medical Center. PARTICIPANTS: Patient. INTERVENTION: Magnetic resonance imaging, surgical resection of the cyst, clitoroplasty. RESULTS: Clitoroplasty with removal of the intradermal cyst and resolution of pain. CONCLUSIONS: A 17-year-old immigrant female presented with clitoral pain associated with clitoromegaly. Epidermoid cysts are usually solitary, asymptomatic, slow-growing, proliferations of epidermal cells that are commonly present on the neck, scalp, face, or trunk. There have only been four reported cases of epidermoid cysts of the clitoris not associated with female genital mutilation. The cyst in this case was removed by local excision, and the patient’s pain has resolved.

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